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General NPI Number Information
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NPI Number | 1285761064
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Entity Type | Organization
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Legal Business Name | UPMC COMMUNITY MEDICINE INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 1600 WILDLIFE LODGE RD SUITE 300 BURRELL MEDICAL CENTER
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City | LOWER BURRELL
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State | PA
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Zip | 15068-3641
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Country | US
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Telephone | 724-226-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 WILDLIFE LODGE RD SUITE 300 BURRELL MEDICAL CENTER
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City | LOWER BURRELL
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State | PA
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Zip | 15068-3641
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Country | US
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Telephone | 724-226-1400
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARK EHALT
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Credential |
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Telephone | 412-647-0943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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